Speaking of Psychology - Psychedelic therapy: Will it be a game changer for mental health treatment? with Albert Garcia-Romeu, PhD

Episode Date: March 15, 2023

In just a few years, psychedelics have gone from being a symbol of the 1960s counterculture to being touted as highly promising mental health treatments. Dr. Albert Garcia-Romeu, PhD, of Johns Hopkins University, talks about whether the research backs up the hype; the state of psychedelic therapy research for PTSD, depression, addiction and other mental health disorders; how psychedelics work in the brain and mind; and whether psychedelic treatments are likely to be approved in the U.S. any time soon. Please help us know more about you and what you would like to hear more of from Speaking of Psychology by filling out our 2023 Audience Survey. For transcripts, links and more information, please visit the Speaking of Psychology Homepage. Learn more about your ad choices. Visit megaphone.fm/adchoices

Before we get started today, I'd like to ask you to take a moment to fill out our listener survey. We'd like to know more about what you think of this podcast and what you'd like to see us do more of. We'd also like to know more about you. So if you would, please go to our website, www.Speakingof Psychology.org, and click on the link to our listener's survey. It should not take you long to complete. We'd really appreciate it. Now, on to the episode. We first talked about psychedelic therapy on this podcast three years ago. Since then, interest in psychedelics has skyrocketed.

Two states, Oregon and Colorado, have voted to legalize psilocybin use by adults. And just last month, Australia became the first country in the world to recognize psychedelics as medicines. Doctors there will be able to prescribe psilocybin for depression and MDMA, popularly known as Ecstasy or Mali, for post-traumatic stress disorder. Meanwhile, researchers are studying psychedelic treatments for anxiety, addiction, and other behavioral health disorders. So how did these drugs go from being a symbol of the 1960s counterculture to being touted as among the newest, most promising mental health treatments? And does the research back up the hype?

How do psychedelics work in the brain? What have scientists found out about the types of mental health problems they can treat? What's the legal status of these drugs? Are they likely to be approved as medications in the U.S.? And if they are, who will provide these treatments and who will have access to them? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills.

My guest today is Dr. Albert Garcia-Romeau, a psychologist and a member of the Psychiatry and Behavioral Sciences faculty at the Johns Hopkins University. School of Medicine. He is also a guest researcher at the National Institute on Drug Abuse. Dr. Garcia-Romew studies the effects of psychedelic drugs in humans. His research interests include clinical applications of psychedelics, mindfulness and altered states of consciousness and their underlying neurobiological mechanisms, as well as real-world drug use patterns and impacts on public health. He has also published dozens of research papers and has been widely interviewed in the media on psychedelic research. Dr. Garcia-Romeo, thank you for joining me today.

Yeah, thank you for having me. I mentioned a couple of drugs in the introduction that our listeners have probably heard of, psilocybin and MDMA. How do you define a psychedelic? What drugs does the term encompass? Can you explain what each of them is and how they're similar and how they're different? That's a lot of questions, and I can teach a whole class about that, but we'll try to go, We'll try to break it down into some of the basic components there. The term psychedelic was actually coined by a psychiatrist named Humphrey Osmond back in 1957,

and he was interested in drugs like LSD and mescaline, which are what we call classic psychedelics. They're serotonin-2A receptor agonist drugs, and that's just pharmacologically the mechanism. That's the way that they work in the brain, as far as we can tell. Sillus Simon is another one of these classic psychedelics. And so is DMT or dimethyltryptamine, which is found in the human brain as well as many plants and animals, and is found in ayahuasca as well. And so there's a sort of canonical group of what we call classic psychedelics. Most of those are naturally occurring. So, you know, I mentioned mescaline, which is found in peyote cactus and San Pedro cactus.

I've talked about DMT, which is found in different types of plants and animals. also psilocybin, which is found in about 200 different species of mushrooms that grow all over the world. And then, you know, LSD is sort of the semi-synthetic derivative that came out. That was sort of, you know, brought the psychedelics into the limelight, if you will, during the 20th century. And, you know, you mentioned the counterculture. The LSD was definitely, you know, heavily involved in that period as well. And so that was something that was synthesized in the laboratory. back in 1938 by a chemist named Dr. Albert Hoffman, but it works by the same mechanism as

these other classic psychedelics, this serotonin 2A receptor mechanism. And so we grouped those together. And when Osmond was studying these drugs, or back in the 1950s, they were trying to find a better name for them because people were usually referring to them as psychotomimetics, meaning that they seem to mimic a psychotic state. And after working with these drugs and taking them himself self-experimenting, he didn't feel that that was an accurate label. He felt that there was more to the drug effects than that. And so he and the British author, Humphrey Osmond, were actually going back and forth trying to figure out, you know, how do we call these drugs this more accurate representation of their effects?

And, you know, Huxley had famously written about his experience with Mescalan in a book called The Doors of Perception. And eventually they landed on, Osman proposed the word psychedelic because it was meant to characterize that this was a drug that was sort of uncovering something that was in the psyche. It was allowing something in the psyche to manifest or to be revealed. and that was his, you know, using the Greek terminology to sort of come up with a new label. And that really is the beginning of that term specifically back in the 1950s. However, you know, since then, the word psychedelic has been used in so many different ways to talk about artwork, to talk about music, to talk about culture. And so, you know, the very strict sort of pharmacological classification is not always the way that people,

people talk about these drugs in real life. And certainly MDMA and even cannabis at times have been sort of lumped in with these psychedelics or drugs that can cause psychedelic-like states, whatever that means. And so MDMA, although it's not exactly the same from a pharmacological standpoint as some of these other classic psychedelics, it does induce a really strong altered state of consciousness, which is one of these key factors that people look at in terms of creating what you'd consider a psychedelic effect. And so people often talk about MDMA as a psychedelic, though it's also been talked about as being an intactogen, for instance,

which means it allows a person to access what's within their mind and their emotional states. So, yeah, there's lots of different ways that we talk about these. And even now, scientists, myself included, are going back and forth talking about, you know, what does psychedelic really mean and what is the definition of psychedelic? medicine. So it's an interesting time because the field, I think, is coming back to grapple with some of these terms and what do they mean. What about the drug ketamine? It's often lumped into the psychedelic category and it's the only one of these drugs that's FDA approved and people can get a prescription for right now. Is ketamine a psychedelic? So ketamine is a slightly different drug.

It's what I would call it a dissociative anesthetic. It's been around for a long time. we use it for anesthesia, you know, in medicine, and both animals and humans all the time is pretty common place. But when you use a sub-anesthetic dose, basically a dose that doesn't knock a person out, they can also have these psychedelic-like states, which include feelings of being outside of one's body and having different types of altered states of consciousness. And again, when you're talking really broadly about a drug that can create an altered state, that's usually the sort of loose usage of that word psychedelic. And so people talk about doing, for instance, psychedelic therapy using ketamine. But when you're doing that, you know, the, again, the pharmacological mechanisms are

slightly different than they are from the class of psychedelics or from MDMA. So is ketamine operating on the same part of the brain or someplace, so it's someplace different in the brain? Well, the mechanism behind the drug action is more rooted in the glutametergic system and the specific NMDA receptors that are part of the glutamate system. So we know that that seems to be one of the targets for these drugs that's slightly different from the classic psychedelics that work more in a serotonin system. But ultimately, you know, we're talking about the same brain and the same brain networks, and they end up having quite a bit of overlap, it seems, in terms of the type of effects

that people are experiencing when they're under the influence. And so, for instance, one of the types of experiences that people often will talk about when they have either sub-anesthetic ketamine dosing or dosing with a classic psychedelic is this unitive state, this feeling of the boundaries between self and other sort of coming down and feeling more interconnected with the world. And those types of experiences can be occasioned both by the classic psychedelics, but as well as ketamine and other types of practices like meditation. and so forth. Has the huge uptick in public interest in psychedelics over the past few years come as a surprise to you? And has doing work in this area changed over the last decade? So I would say yes. I think it's been a little bit surprising to see how enthusiastic popular culture has become about all the work that's happening in this field.

And, you know, the prospects of psychedelic therapies, I think, you know, many people would have said 10 years ago that, you know, they would have been skeptical about sort of widespread adoption of this type of treatment in a medical setting. And nowadays, it seems almost imminent. And actually, with MDMA, we will be seeing that in practice, you know, in the U.S. as early as next year. And then, as you mentioned, ketamine is already available. And there is growing interest in using ketamine in this way because it's not something that had been practiced, you know, in a widespread fashion to be doing this type of ketamine therapy. Only until recently did there become, again, growing interest in market for something like that. And so now you're seeing the growth of that to provide those types of services from different companies out there. So what are the mental disorders that psychedelics can treat?

I mentioned in the intro that Australia approved treatments for depression and post-traumatic stress disorder. Is that where the evidence is the strongest at this point? Yeah. So there's been a lot of work. It sort of started, again, with the classic psychedelics back in the 1950s and 60s. You saw a good amount of research. Then that sort of died down for some time after backlash and criminalization in the 1970s. But really, since the late 90s, early 2000s, you start to see.

another uptick in research. And yeah, you noted a couple of different conditions. So the ones that are very close to approval for, for instance, MDMA is use of MDMA with talk therapy for post-traumatic stress disorder, PTSD. And so that's actually undergone two phase three clinical trials now that were sponsored by the Multidisciplinary Association for Psychedelic Studies, MAPS, and, And in both of those studies, although the second study has not yet been published, the results have been overwhelmingly positive. And they found a lot of remission of symptoms and improvement in mental health status in these folks who were going through the study.

They're getting, I believe it was three doses of MDMA during the course of treatment, which lasts about 12 weeks. And there's preparation before and after the drug is administered. and, you know, in the intervening weeks, there's often different types of counseling or talk therapy going on. And the people who are getting those types of treatments versus placebo are showing a far greater response rate. And so you're seeing a majority of people who get that MDMA therapy with PTSD are improving above and beyond what they would be doing with just the talk therapy alone. And so those are the types of data that are necessary in order to get a medical approval through the FTC. And at this point, you see that is, again, very close with MDMA. And so by next year, it's seeming as though you're going to see a change in the classification of MDMA.

So it's no longer considered Schedule 1, but it can be prescribed by physicians and clinicians who want to use it to help people with PTSD. And, yeah, that's where I would say most of the evidence with MDMA therapy has been focused so far. Other folks are working on looking at MDMA and treating things like substance use disorders or other types of mental health conditions. But so far, yeah, PTSD has been the big one. So what's happening in people's brains, say, if you're taking MDMA for a substance use disorder? I mean, why would that work as opposed to any of the other treatments that are out there right now? I mean, what's the difference between that and say antibuse? Well, antibuse is definitely not one of these drugs as well-tobuse.

People don't usually like to use it because, you know, if they just, if they want to drink, then they just stop taking the medicine. And, you know, there's lots of different types of substance use disorders and treatments for those that vary widely. But what I think sets apart these psychedelic therapies is that usually with a course of talk therapy and somewhere in between one and three drug administrations over the course of a few months, you're usually able to help people move. beyond sort of not just the problematic behavior, which would be, for instance, you know, alcohol or drug use, but often to kind of get to the root of the issue to psychologically work through some of the presenting problems that are related to the reasons why they use those substances to begin with. And so I think a lot of current treatments are focused on masking things like withdrawal or craving or trying to keep people so that they're able to avoid, using the drug sort of on a very surface level, but when you start to go down into the deeper roots of why it is that they're doing those types of behaviors, then you're able to really make long-term lasting changes. In terms of, you know, what are they doing in the brain? That's still

really a big mystery, I would say. We've seen a lot more research over the last decade or so looking at psychedelics and MDMA to understand their brain mechanisms, but we're really still unpacking those and trying to differentiate what the different types of drugs are doing and why they have the impact that they do, meaning that you're seeing long-term changes, including things like, you know, months or later, people are still showing improvements, which is not the case with a drug like Antibuse, for instance, or like SSRI standard antidepressant, because when you stop taking those and they stop working. How much is known about how these drugs are helping people where other treatments don't?

for example, using psilocybin to treat persistent depression? So that's actually an area has been an active study, and particularly with psilocybin, as you noted, you know, that's well far along in terms of studying that as an antidepressant treatment, both in people with major depression, but also in people with treatment-resistant major depression, which is a person who's failed multiple different, you know, failed to improve after taking multiple different types of treatments or medications. And so, yeah, those cases, you know, are usually thought of as being a little more serious because people are not responding to the traditional therapies and treatments that are available. And so in those cases, what they found is that, you know, in a nice, large study that was published, this is actually the biggest study published on psilocybin so far.

And it was about 230 people or so with treatment resistant depression. and they either got one high dose of psilocybin, which is 25 milligrams, or they got 10 milligrams of psilocybin, which is a moderately low dose, or they got a placebo-like dose of one milligram of psilocybin that usually doesn't have much of an effect. And they were able to see that the people who got that single high dose were showing improvements in their depression on average. It lasted out to three weeks after the drug. And again, that's, you know, first, different in a couple of ways from our standard treatments. First, you know, those people are getting symptom improvements immediately after they've gotten the drug dose. And that's different than a lot of our standard antidepressant medicines that usually take weeks to start working. And the other thing is these are people who had already failed to respond to other types of medications,

and yet they are still seeing these improvements in their depression that last weeks after. the single dosing. And, you know, that's not even taking into account other studies like ours here at Hopkins where people got two doses and are showing symptom remission and improvements that last up to a year later. And so really, that is exciting because for a lot of people who are not responding to current treatments, you know, we need something new. We need something that works better.

And the idea that you could take one or a few doses of this drug and, you know, supplement that with some talk therapy and see these long-lasting benefits is in many ways revolutionary for the field. Are there certain people who should not take psychedelics for problems that they have? For example, I've read that these drugs could be harmful to people with bipolar disorder. Why is that? There's concerns, and there have been case studies and other data from people who have used these psychedelics out in the world, who have then gone on. to develop manic symptoms, you know, and that obviously can be problematic. We don't want to,

you know, put anyone on a course where their mental health status is going to deteriorate after you give them a high dose of the drug. And so, you know, that's been one area where people have been very careful and excluding folks who have bipolar mood. However, there are preliminary data showing that people who get psilocybin who have a milder form of bipolar mood, seem to respond well and have not seen these incidents of mania. However, you still get the case reports from people out in the community who have had those types of situations. And so obviously, it's still an open question.

And it's an area that I think requires more study. The main area that we know that, you know, people who receive high-dose psychedelics may have lasting problems afterwards would be people who have a predisposition to psychotic illness, schizophrenia, those types of conditions. If they either have a personal or family history of one of those disorders or if they've, you know, had symptoms of that type of condition, we would often screen those people out of our research studies, mainly because you would be, again, trying to avoid precipitating ongoing problems, including things like psychotic symptoms that can last, you know, for months or longer if, you know, things don't go the way

that we want them to. Some of the people who are listening to this may themselves be experiencing some syndromes where they think that these kinds of drugs might be helpful to them. And where does the average person go to participate? Say it's got to be a clinical trial at this point, right? I mean, because most of this stuff is not approved for general use. Right. Well, I mean, there are many people who are trying to self-treat or to find treatment

underground, that even in places where legalization or decriminalization might have occurred, that's still illegal at the federal level. So, you know, there are penalties for that, criminal penalties and other things that can happen that are problematic. But in terms of, you know, finding something legally available in the U.S., particularly, yeah, you'd want to go to a website called clinicaltrials.gov. And that's, you know, a registry where all the clinical trials that are happening, both here and abroad are listed out.

You can look by condition. You can look by keywords such as SILA simon, for instance. You can look by location and try to find things that are available. I would say even though the work is growing, there's still just a few hub regions where you can get a lot of research happening. And otherwise, you know, there's a lot of folks who not necessarily have access because either the work is not happening near them, or the clinical trial inclusion criteria are very strict, which they tend to be, you know, primarily for safety safety.

Sure. So what's the outlook for these drugs being approved as medications in the U.S.? You mentioned MDMA seems close, but what about psilocybin? What about some of the others that you mentioned, DMT, that comes from ayahuasca, things like that? Well, psilocybin is probably the next closest to approval, I would say, because there's, There's been such a preponderance of research looking at it for depression and then also for other conditions like substance use and existential distress. And so my forecast, if you will, would be that within the next three or four years, you'll likely see psilocybin getting into that approval process with the FDA as a new treatment, something that will be then accessible to people who are able to get psilocybin treatment by a licensed clinician, particularly for things like. major depression, which is where, again, a lot of the data have been so far. There's not a lot of

widespread study right now of other types of psychedelics, LSD, mescaline, DMT. There's been small studies here and there. The regulatory red tape to do this work, and then also the sort of regular or typical form of medication approval in this country, you know, kind of make it difficult to do this work because between the regulatory approvals and hurdles that we have to get jump through to do this, the enormous cost of doing the research. And then if you're talking about something like LSD, for instance, that's not a patentable molecule because it's been around for so long, then it makes it quite difficult to move it through this process and to get people to invest in that because why would anyone spend money to study it if they can't get a return on investment

from a capitalist standpoint. So, yeah. Right. So those are the drug manufacturers, the ones who have the money to go through the process. Correct. But, you know, since they don't own those molecules, then they don't feel compelled to study them. And so that's why you've seen such a long process with something like MDMA or psilocybin, where the funding to do this research has sort of come in piecemeal over the course of literally decades to get it to where we're at with the science.

Now, you've written about equity and access issues, both in terms of who is being included in the research trials on these drugs, but also who might have access to the treatments eventually. Can you talk a little bit about that? Yeah. Well, you know, it's been pointed out that many of the research studies that have been published using MDMA or psilocybin have been predominantly white, predominantly high socioeconomic status participants. And there's a number of structural reasons for that. And then there's a number of cultural reasons for that as well, I think. But we'll say I think it's over 85% of participants in the clinical trials that to date have occurred using psilocybin and MDMA have been white. And if you want to kind of think about why is that, you know, some of those structural reasons that I mentioned include things, factors such as just not being able to get off of work,

spend a whole day in a therapy session like this and, you know, being able to do that multiple times or not being able to get away from child care or domestic issues that have to be taken care of. So that, you know, that's one thing that I think is really skewed this work in a certain way. Culturally, I also think that there's a lot of mistrust of the medical institutions and biomedical research for a number of reasons, historic abuses, things of that nature that, you know, I think make people mistrustful of coming to do a study where you're going to take a drug that if you, you know, have read popular media, you might think, well, this drug might make me go crazy or this drug, you know, is going to make me feel really strange. And I don't know who,

you know, who's going to be around me or what's going to happen or what are they going to do to me. And so I think that can be a really very real concern for people, not to mention, you know, the years and years of criminalization and stigmatization of drugs and drug use in general that make people probably raise an eyebrown and say, you know, they want to take me into the laboratory and give me this illegal drug. I don't know if I'm comfortable with that. And so, you know, I think that's a big problem with psychedelic research to this point is that it has been predominantly white, predominantly high or socioeconomic status participants. But, you know, this is something that actually, you know, is parallel in all sorts of biomedical research. And so

it does point to these bigger problems, which is, you know, you see less than 5% of people who are in trials of new FDA-approved medications in the 90s and 2000s were coming from black, African-American, Hispanic backgrounds. And so you're seeing, again, a very homogeneous population in many of these studies for any sort of medical research. And that's a problem. And the other problem, I think, at another level, is that many of the researchers themselves are not representative of the broader community. And so you see less than 5% of the researchers doing these studies are coming from a black, African-American, Hispanic, indigenous background. And so that also, I think, would make people hesitant to necessarily

want to come in and feel invested to do this type of thing. So, you know, there's, there's I think many different layers there to be unpacked. But ultimately, you know, I'm hoping that both the researchers and the participants are able to diversify over the next decade. And that also, you know, should this type of treatment be approved soon, that we're going to find ways to make that available and accessible to people, particularly people who are coming from lower SCS backgrounds because they often have big health disparities and issues that they need to to deal with that include many of the types of problems that we're talking about, post-traumatic stress, substance use, depression, and so on.

Oh, that all makes sense. I want to change gears a little bit and talk about microdosing, which is taking small amounts of some of these drugs on a regular basis to treat a variety of issues. Now, proponents say that taking tiny doses of psychedelics that are too small to have real psychedelic effects can help with mood, creativity, productivity, and all sorts of things. Is there any research that backs this up? Not really. So, I should say there's not really a lot of research to begin with.

Most of what we have is anecdotal. And you can collect anecdotal data from lots of people, and this has been done both sort of retrospectively and prospectively. But, you know, there haven't been a lot of well-controlled trials. There's only been a few small studies of microdosing in psilocybin and LSD. They haven't shown anything that, to me, shows a clear signal of benefit. More than anything, what I imagine we're seeing often is some sort of placebo effect where people know they're taking something and they feel like they're feeling better as a result,

whether or not the substance is doing something. Now, I do think that there's a real possibility for microdosing to have therapeutic benefit, it, but it's really hard and expensive to study it properly, to do a double-blind placebo control study, for instance, in dozens or even, you know, hundreds of people to actually test this out. And so until that happens, I would say the jury is out, you know, we don't really have a good answer. I've certainly spoken to lots of people with very convincing anecdotal reports of getting better from all sorts of different conditions, from using micro doses of psilocybin, for instance. But, you know, nobody's actually drilled down into a cohort of someone,

of people, for instance, with major depression and studied this carefully. And so until that happens, I think we can't really make a conclusive statement. Would you say that it's dangerous for people to engage in microdosing? I mean, people are able to get their hands on some of these drugs and sort of do it themselves at home. I mean, is that a good thing? I mean, I wouldn't advocate for that. I mean, it's illegal. People have lost their jobs, for doing that kind of thing. You know, depending on what you're taking, it can be really hard to tell what it is that you have. If you're talking about, for instance, a synthetic molecule like LSD, you may be getting something very different than what you think you're getting, which could have significant adverse health effects.

With psilocybin mushrooms, you know, that's something that people can find because they grow out in the world. And, you know, the only thing I would say there is you may not have the types of mushrooms you think. you have and, you know, obviously measurement can be difficult, but otherwise, I would say that the classic psychedelics, if you know what you have and how much you're taking, they're relatively safe for most people. And that's, you know, due to the fact that they don't really cause any toxic effects on our major organ systems. And so taking small amounts of them shouldn't be problematic. Although there, again, a lot of open questions. You know, people have talked about serotonin-2B receptor properties of psilocybin, for instance, and how that can cause heart valve problems.

And that actually was related to a medication called fenfin that was being used for weight loss years ago. It was pulled from the market because of those same heart valve problems. And when you take psilocybin treatment, for instance, with one high dose, you wouldn't have to worry about that because it's not a chronic dosing regimen. But if you're taking that often over and over again, that does lead to potential, for instance, to develop some of these problems. So again, there's still a lot we don't know.

And so I would certainly, again, not advocate for that type of treatment, but certainly there's a lot of people who, you know, feel desperate and, you know, they're looking for something to help them. And I can understand that, you know, based on where we're at with limited treatment options, that people are exploring all sorts of different things. Do you worry that some of these psychedelics are being overhyped or advertised directly to the public, for example, there was an opinion piece in the New York Times recently headlined,

why are ketamine ads following me around the internet? And it was about how ketamine is being pushed, you know, by targeted social media ads. Is this a problem? I think it can be, yeah. I mean, you know, just us right now having these conversations, you know, it's likely that we may get one of those ads pop up later on our own social media. But, you know, what I do think is that there has been a significant overhype of what's going on with the science.

Yes, these drugs seem to have a remarkable therapeutic potentials. And yes, for many years, they've been stigmatized and talked about as this sort of, you know, really dangerous drugs of abuse. But, you know, flipping the script and saying, you know, these are a panacea, you know, these are going to save the world, you know, because and that was a. headline directly pull for Roman Stone, you know, can psychedelic save the world? You know, that type of sensationalism, I don't think is helpful for the general public to be consuming and particularly for vulnerable populations, including people who are struggling with mental health conditions to, you know, see that type of media and then, you know, not really know what is the state of the science because, again, often it's overblown. We know that ketamine has significant

antidepressant effects. I mean, we've known that for a long time now. And so if people can get access to it and they have serious depression, they can get often relief from that, you know, in a ketamine treatment setting. But, you know, when you're starting to go out and try to market that or basically sell that to people aggressively, yeah, I think you're running up against some real potential ethical issues. So what avenues of research are you finding the most exciting right now?

I'm excited by the prospect of medical approvals by FDA in the next few years because I do think that's really going to revolutionize the landscape of mental health care in this country. I think that it's going to change the model somewhat from what it has been, where we had sort of top therapy siphoned off on one side and then pharmacotherapy or medications on the other side and sometimes people would be doing both, but often not in an integrated fashion. And what's nice about these treatments is that they bring both together in a comprehensive package and the psychedelic treatments themselves are so different than what's available right now. And why I say that is because, as we discussed earlier, you know, they really kind of bring you into yourself

and what it is is the root of your issues, whether that be relationship problems, past trauma, you know, issues that you have with self-esteem, you know, all these different types of things that can be wrapped up in, you know, a mental health diagnosis can be sort of unraveled somewhat during the process of this time, this kind of psychedelic therapy, and then allow people to really resolve them and not just to sort of cover them over with the standard types of therapies that we have available right now. And you can't often do that in talk therapies, obviously, over the course of the long period of time. But we usually will have our walls up and our defenses there to try to keep things

from changing too fast because that can feel very threatening and scary. But with psychedelics, it can kind of allow us to make a very deep dive very quickly. So I think that's most exciting to me. But with the research, you know, you're just seeing more and more research branching out. And so, for instance, you know, we're starting to do research. now with psilocybin and patients with early stage Alzheimer's disease here. My colleague, Dr. Nali Gukassian is working on a nice study that she's just wrapping up in psilocybin and people with anorexia nervosa. So starting to look at these different areas where we are in clear need

of knee treatments and exploring the potentials there, you know, I think is also really exciting because it's a new horizon for us. We've actually known for a long time that we've actually known for a long time that we could use psychedelics to use to treat addictions, existential distress, and, you know, because it was being done back in the 60s. But now we're kind of getting back to the place where we can reestablish that using rigorous and contemporary research methods. But now there's all these other questions that are on the horizon, including, you know, those new clinical conditions on the one hand, but then also the biological and psychological mechanisms that underlie these drug effects because it is a mystery. You know, we talk about how the brain is reacting to these drugs,

but it's more than just how is the brain responding. It's how is the mind responding because that's where you start to see changes in the sense of self-identity, for instance, in a person who's been struggling for years who identifies as a person with a problem with particular substance, for instance, and is able to change that sense of identity in a way that allows them to live the rest of their lives in a healthier way. And so that, you know, I find unique among all the different types of treatments that are out there. Well, Dr. Garcia-Rameo, I want to thank you for joining me today. This has been really interesting.

I think what you're doing is very exciting, and we will stay tuned. Yeah, well, thanks so much for having me. I really appreciate it. You can find previous episodes of Speaking of Psychology on our website at www. www. speakingof psychology.org or on Apple, Stitcher, YouTube, or wherever you get your podcasts. And if you like what you've heard, please leave us a review. And again, we'd like to hear from you about what you think of this podcast and what you'd like to hear more from us. So please go to our website, www.spicingsychology.org, and look for the link to our listener's survey.

If you have comments or ideas for future podcasts, you can email us at speaking of psychology at APA.org. Speaking of psychology is produced by Lee Winerman. Our sound editor is Chris Condayan. Thank you for listening. The American Psychological Association. Mills.